AB0994 HOW SPONDYLOARTHRITIS PROFILE HAS EVOLVED OVERTIME: RESULTS FROM GESPA COLOMBIAN COHORT
Authors: J. C. Santacruz Devia, J. Londono, A. M. Santos, G. Rodríguez Salas, I. Rueda, M. J. Mantilla, J. Rueda, S. Arias, J. M. Bello-Gualtero, E. Calvo, M. Cardiel, C. F. Pacheco Tena, V. Navarro-Compán
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Over the last two decades, our knowledge of spondyloarthritis (SpA) has been improved. The awareness of this disease within the medical community and the implementation of advances in clinical practice are unclear, especially in some geographical regions less well represented in research studies. <h3>Objectives</h3> The aim of our study was to evaluate the changes overtime in disease profile in patients with SpA from a Colombian cohort. <h3>Methods</h3> Data from 471 patients recruited in a prospective Colombian cohort of Spondyloarthritis patients (diagnosed according to rheumatologist), with registries from 90' to the date was analyzed. Three time periods were stablished for the analysis, the first period from the first registry until October 10, 2003; the second period from October 10, 2003 to October 26, 2010; and the third period from October 26, 2010 to December 31, 2021. The patients were reclassified according to ASAS classification using the information available, and judgment from a group of four expert rheumatologists. <h3>Results</h3> 471 patients were included in the study, period 1 (n = 158), period 2 (n = 150) and period 3 (n = 163). There were no differences in sex distribution across three periods. Time to diagnosis was shorter in period 1 than 3 (table 1). The frequency of r-AxSpA diagnosis was proportionally higher in period 1 (47.5%), than period 2 (38.2%), and 3 (31.3%), P = 0.013. For another hand, the frequency of nr-AxSpA diagnosis was lower in the period 1 (9.5%) than period 2 (15.1%), and 3 (22.1%) (view graphic). The frequency of peripheral SpA diagnosis was similar across the three periods (38% vs. 39.5% vs. 37.4%, for periods 1, 2 and 3 respectively, P = 0.8). The presence of dactylitis at physical examination was most common in the first period (10.8%) than the last two periods (3.3% and 3.7%), P = 0.007. There were no differences in frequency of dactylitis, arthritis or uveitis. There were no statistically significant differences in frequency of HLA-B27 (42.4% vs. 44.8% vs. 48.6%, for periods 1, 2 and 3, respectively, P = 0.2) or HLA-B15 (14.4% vs. 8.2% vs. 15%, for periods 1, 2 and 3, respectively, P = 0.2) across the three periods. The metrology analysis showed higher physical limitation in the first period (thoracic expansion &lt; 2.5 cms and modified Schober &lt; 5 cms) than in the last two period (view table 1). The history of psoriasis in SpA patients was higher in period 1 (7.6%) than period 2 (2.6%), and 3 (2.5%), P = 0.036. Infections preceding SpA symptoms onset were most frequent in period 1 (32.9%) than period 2 (29.6%) and 3 (16.6%), P = 0.002. <h3>Conclusion</h3> The profile of patients with SpA has evolved over time in Colombia. While the frequency of peripheral SpA has remained unchanged over time, the incidence of non-radiographic axial forms has increased over time. Furthermore, functional limitation in SpA, infections preceding symptoms, and dactylitis are less common than 20 years ago. These results highlight the impact of advances in rheumatology and the awareness of the medical community about this disease in Colombia, allowing an earlier diagnosis or the diagnosis of less evident forms of SpA. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.